Gender differences in the duration of non-work-related sickness absence episodes due to musculoskeletal disorders

J Epidemiol Community Health. 2016 Nov;70(11):1065-1073. doi: 10.1136/jech-2014-204331. Epub 2016 May 13.

Abstract

Background: There is wide evidence that women present longer duration of sickness absence (SA) than men. Musculoskeletal disorders are influenced by gender due to the sexual division of work.

Methods: 354 432 episodes of non-work-related SA due to musculoskeletal disorders, which were registered in Catalonia between 2005 and 2008, were selected. The outcome variable was the duration of SA. Frailty survival models, stratified by sex and adjusted for explanatory variables (age, employment status, case management, economic activity and repeated episode), were fitted to study the association between each variable and the duration of SA, obtaining HRs.

Results: Women presented longer SA episodes than men in all variable categories. A trend from shorter to longer duration of SA with increasing age was observed in men, whereas in women, it had a fluctuating pattern. Analysing most frequent diagnostic subgroups from the sample, only 'non-specific lumbago' and 'sciatic lumbago' showed these age patterns. Frailty survival models applied to these 2 subgroups confirmed the described age patterns in SA duration.

Conclusions: Women have longer non-work-related SA due to musculoskeletal disorders than men. However, while men have longer absences as their age increases, in women some older groups have shorter absences than younger ones. These findings could be explained by gender differences in the interaction between paid work and family demands. Our results highlight the need for continued research on SA from a gender perspective, in order to improve management of SA in terms of clinical practice and public policies.

Keywords: GENDER; Health inequalities; OCCUPATIONAL HEALTH; SICKNESS ABSENCE.

Publication types

  • Observational Study

MeSH terms

  • Absenteeism
  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / epidemiology*
  • Retrospective Studies
  • Sex Factors
  • Sick Leave / statistics & numerical data*
  • Spain / epidemiology